Friday, June 20, 2014

White House Summit on Herion and Prescription Drugs


Governor Peter Shumlin from Vermont stepped to the podium at the White House Summit yesterday to address the opioid epidemic sweeping our country. Our country has seen a drastic rise in Heroin use over the last few years and Governor Shumlin remarked that the majority of Heroin addicts begin with prescription drugs. It affects all types of people across all classes. He asked the provoking question “What do we do?”
Three areas he addressed:
     1. There has to be a system to treat the problem.
He talked about the Hub and Spoke System. There must be a place for addicts to go and people there to help. 
     2. How we treat addicts has to be considered.
Evidence Based Expedited Treatment is an approach Vermont has now set in place to help addicts at the most crucial and vulnerable times. “Opioid addicts are the best liars and the best deniers” Governor Shumlin remarked. We must get addicts to “face the music” and realize the seriousness of their problem. Often arrest brings this, and law enforcement is critical. But what often happens is an addict is arrested, several months later sentenced, and by that time they are back to using and that moment of serious reality has passed. There needs to be Immediate Assessment. They need to be treated immediately while they are still in the midst of realizing the seriousness of their addiction (i.e. directly following an arrest, near death experience, etc.). Vermont has enacted a new policy that following an arrest the addict goes into a treatment program immediately and if they succeed they will not be charged. Then they are helped back into society as a productive citizen. The motivation for recovery is much higher.  

Over 100 Americans die a day from opioid overdose.

He proceeded to address the silence and stigma toward addicts our country holds, which only serves to allow the problem to grow.
           3. We need to get over the stigma.
The greatest problem the community faces in addressing addicts is fear. The ever growing problem of opioid abuse is under talked about and under treated. But communities must be involved. Be proactive. If you find someone who is an addict, get them, bring them out, and bring them into recovery before it goes to the law. “We all have to roll up our sleeves and get involved” stated Governor Shumlin as he urgently pointed out that addiction “can destroy American life!”

Following Governor Shumlin’s passionate speech, scientist and director of the National Institute on Drug Abuse (NIDA), Dr. Nora Volkow focused on the physiological impact of opioid use on the brain. She explained that opioids impact the opioid receptors in the brain which trigger the reward system and relieve pain. Opioid addiction weakens the body’s ability to naturally produce these reward responses and increases the body’s need to find this satisfaction through drugs.  

Dr. Volkow piggy-backed Governor Shumlin’s urge to talk about the problem of opioid abuse in our states. She expressed that in approaching this subject “we need courage and we need honesty.” Whether we talk about it or pretend it doesn’t exist, opioid addiction is a drastically increasing problem across our nation. In our silence we allow this rampant death toll to continue to sweep our country. 

The epidemic exists in part because of ease of access and availability of opioid drugs as well as through social norms. One social norm; the belief that opioid drugs are safe because they are prescribed by doctors, maintains the substance abuse crisis. Truths our communities need to become aware of:
  • The same drug can have very different effects on different people.
  •  Simply because a drug is prescribed by a doctor does not make it safe for anyone to take.
  • Doctors need to treat their patients for pain AND addiction.
Lack of knowledge on opioid addiction does not prevent patients from getting addicted.
  •  Doctors need to be educated on how to recognize addiction.
  • We need to increase implementation. The evidence is already there.
Over the last 10 years we have seen a five-fold increase in prescription drug abuse.
In 1 year there has been a 30% increase in Heroin overdose.

Nora Volkow passionately concluded, “We have the tools to save lives. What we need is the will to do it. We need to act, and we need to act urgently!”

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